Song Ju Myung, Kim Ji Hoon, Lee Yoon Suk, Kim Ho Young, Lee In Kyu, Oh Seung Teak, Kim Jun Gi
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Surg Treat Res. 2016 Oct;91(4):195-201. doi: 10.4174/astr.2016.91.4.195. Epub 2016 Sep 30.
Laparoscopic surgery was previously accepted as an alternative surgical option in treatment for colorectal cancer. Nowadays, single-port laparoscopic surgery (SPLS) is introduced as a method to maximize advantages of minimally invasive surgery. However, SPLS has several limitations compared to conventional multiport laparoscopic surgery (CMLS). To overcome those limitations of SPLS, reduced port laparoscopic surgery (RPLS) was introduced. This study aimed at evaluating the short-term outcomes of RPLS.
Patients who underwent CMLS and RPLS of colon cancer between August 2011 and December 2013 were included in this study. Short-term clinical and pathological outcome were compared between the 2 groups.
Thirty-two patients underwent RPLS and 217 patients underwent CMLS. Shorter operation time, less blood loss, and faster bowel movement were shown in RPLS group in this study. In terms of postoperative pain, numeric rating scale (NRS) of RPLS was lower than that of CMLS. Significant differences were shown in terms of tumor size, harvested lymph node, perineural invasion, and pathological stage. No significant differences were confirmed in terms of other surgical outcomes.
In this study, RPLS was technically feasible and safe. Especially in terms of postoperative pain, RPLS was comparable to CMLS. RPLS may be a feasible alternative option in selected patients with colon cancer.
腹腔镜手术曾被视为治疗结直肠癌的一种替代手术方式。如今,单孔腹腔镜手术(SPLS)作为一种最大化微创手术优势的方法被引入。然而,与传统多孔腹腔镜手术(CMLS)相比,SPLS存在一些局限性。为克服SPLS的这些局限性,减少端口腹腔镜手术(RPLS)被引入。本研究旨在评估RPLS的短期疗效。
本研究纳入了2011年8月至2013年12月期间接受结肠癌CMLS和RPLS的患者。比较两组患者的短期临床和病理结局。
32例患者接受了RPLS,217例患者接受了CMLS。本研究中RPLS组显示出手术时间更短、失血更少以及肠道蠕动更快。在术后疼痛方面,RPLS的数字评分量表(NRS)低于CMLS。在肿瘤大小、收获的淋巴结、神经周围侵犯和病理分期方面存在显著差异。在其他手术结局方面未确认有显著差异。
在本研究中,RPLS在技术上是可行且安全的。特别是在术后疼痛方面,RPLS与CMLS相当。RPLS可能是部分结肠癌患者可行的替代选择。